Browsing by Subject "Serious mental illness"

Now showing 1 - 7 of 7
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    A qualitative exploration of stakeholders' perspectives on the experiences, challenges, and needs of persons with serious mental illness as they consider finding a partner or becoming parent
    (Frontiers Media, 2023-01-11) Dubreucq, Marine; Lysaker, Paul H.; Dubreucq, Julien; Psychiatry, School of Medicine
    Background: While many persons with serious mental illness (SMI) consider intimate relationships and becoming parent as central parts of their lives deeply affecting wellbeing and recovery, others anticipate facing multiple challenges in these life domains. This qualitative study sought to explore the perspectives of persons with SMI and mental health providers (MHPs) with diverse backgrounds and practices on the experiences, challenges, needs and expectations of persons with SMI as they consider finding a partner or becoming parent. Methods: For this qualitative study, we conducted five focus groups between March and December 2020 for a total number of 22 participants (nine persons with SMI and thirteen MHPs) recruited from a center for psychiatric rehabilitation and a community mental health center in France. We used the inductive six-step process by Braun and Clarke for the thematic analysis. Results: Participants reported some challenges related to intimate relationships, stigma/self-stigma, disclosure and decision-making about start a family. Their expectations included: (i) psychoeducation about decision-making about finding a partner and starting a family; (ii) support in making empowered decisions about finding a partner, starting a family or disclosure to a prospective partner or their child; (iii) peer-support interventions; (iv) enhancing coping strategies; (v) integrated service provision including home treatment interventions, training to recovery-oriented practices and access to dedicated resources for providers. Conclusion: In short, intimate relationships and desire to start a family for persons with SMI should be more considered in psychiatric rehabilitation and additional support and interventions should therefore be provided.
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    An Investigation of Employment Hope as a Key Factor Influencing Perceptions of Subjective Recovery among Adults with Serious Mental Illness Seeking Community Work
    (MDPI, 2024-03-19) Kukla, Marina; McGuire, Alan B.; Weber, Kenneth C.; Hatfield, Jessi; Henry, Nancy; Kulesza, Eric; Rollins, Angela L.; Psychology, School of Science
    Introduction: Employment is an important contributor to recovery in people with serious mental illness (SMI), yet studies have not explored how subjective elements of employment hope contribute to perceptions of global recovery in this population. Methods: The current study examined the relationship between employment hope and subjective recovery in 276 unemployed adults with SMI participating in a multi-site clinical trial of a cognitive behavioral group intervention tailored toward work and combined with vocational rehabilitation. Participants had diagnoses of schizophrenia spectrum, bipolar, depressive, and posttraumatic stress disorders, and were receiving services at three Veterans Affairs healthcare facilities in the United States. Data were collected at study baseline. Linear regression analysis examined the relationship between employment hope (Short Employment Hope Scale; EHS-14) and subjective recovery (Recovery Assessment Scale; RAS) after controlling for psychiatric symptom severity and mental-health-related burden on daily life. Results: After accounting for covariates, employment hope significantly contributed to the regression model explaining subjective recovery. The overall model of predictor variables explained 52.5% of the variance in recovery. The results further explore the relationships between EHS-14 and RAS subscales. Conclusions: The findings suggest that employment hope is a key intervention target to bolster subjective recovery in this vulnerable population.
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    The effect of limited cognitive resources on communication disturbances in serious mental illness
    (Elsevier, 2017-02) Le, Thanh P.; Najolia, Gina M.; Minor, Kyle S.; Cohen, Alex S.; Psychology, School of Science
    Semantically incoherent speech is a pernicious clinical feature of serious mental illness (SMI). The precise mechanisms underlying this deficit remain unclear. Prior studies have found that arousal of negative emotion exaggerates the severity of these communication disturbances; this has been coined "affective reactivity". Recent research suggests that "cognitive reactivity" may also occur, namely reflecting reduced "on-line" cognitive resources in SMI. We tested the hypothesis that communication disturbances manifest as a function of limited cognitive resources in SMI above and beyond that associated with state affectivity. We also investigated individual differences in symptoms, cognitive ability, and trait affect that may be related to cognitive reactivity. We compared individuals with SMI (n=52) to nonpsychiatric controls (n=27) on a behavioral-based coding of communication disturbances during separate baseline and experimentally-manipulated high cognitive-load dual tasks. Controlling for state affective reactivity, a significant interaction was observed such that communication disturbances decreased in the SMI group under high cognitive-load. Furthermore, a reduction in communication disturbances was related to lower trait and state positive affectivity in the SMI group. Contrary to our expectations, limited cognitive resources temporarily relieved language dysfunction. Implications, particularly with respect to interventions, are discussed.
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    Effects of the Indianapolis Vocational Intervention Program (IVIP) on defeatist beliefs, work motivation, and work outcomes in serious mental illness
    (Elsevier, 2017-04) Mervis, Joshua E.; Fiszdon, Joanna M.; Lysaker, Paul H.; Nienow, Tasha M.; Mathews, Laura; Wardwel, Patricia; Petrik, Tammy; Thime, Warren; Choi, Jimmy; Medicine, School of Medicine
    Defeatist beliefs and amotivation are prominent obstacles in vocational rehabilitation for people with serious mental illnesses (SMI). The CBT-based Indianapolis Vocational Intervention Program (IVIP) was specifically designed to reduce defeatist beliefs related to work functioning. In the current study, we examined the impact of IVIP on defeatist beliefs and motivation for work, hypothesizing that IVIP would be associated with a reduction in defeatist beliefs and greater motivation for work. We also examined the effects of IVIP on these variables as well as work outcomes during a 12-month follow-up. Participants with SMI (n=64) enrolled in a four-month work therapy program were randomized to IVIP or a support therapy group (SG). Assessments were conducted at baseline, post-treatment (4months), and follow-up (1year). Compared to those in SG condition, individuals randomized to IVIP condition reported greater reductions in defeatist beliefs and greater motivation for work at follow-up, along with greater supported employment retention rates. Specifically treating and targeting negative expectations for work therapy improves outcomes, even once active supports of the IVIP program and work therapy are withdrawn.
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    Group-Based Metacognitive Reflection and Insight Therapy (MERITg) and Its Relationship to Recovery-Oriented Beliefs in Serious Mental Illness
    (MDPI, 2024-06-22) Musket, Christie W.; Bullock, Joshua; Fiszdon, Joanna M.; Stacy, Meaghan; Martino, Steve; James, Alison; Lysaker, Paul H.; Schnakenberg Martin, Ashley M.; Psychiatry, School of Medicine
    Group-based Metacognitive Reflection and Insight Therapy (MERITg) is the group application of Metacognitive Reflection and Insight Therapy (MERIT), an evidence-based, integrative, recovery-oriented intervention to enhance insight and understanding of oneself and others in individuals with serious mental illness (SMI). MERITg may offer therapeutic interactions between participants that uniquely support recovery. The goal of the current study was to examine the relationship between MERITg participation and recovery-oriented beliefs. Thirty-one participants (outpatient = 21; inpatient = 10) in SMI treatment programs participated in MERITg as an adjunctive treatment. A short form of the Maryland Assessment of Recovery in Serious Mental Illness (MARS-12) was used to assess recovery-oriented beliefs before and after group participation. Recovery-oriented beliefs significantly improved in the outpatient MERITg group but not in the inpatient group, and change in recovery-oriented beliefs was positively correlated with the total number of groups attended. These findings suggest the promise of MERITg for enhancing recovery-oriented beliefs. The potential role of treatment setting is discussed.
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    How Does Individual Psychotherapy Promote Recovery for Persons with Psychosis? A Systematic Review of Qualitative Studies to Understand the Patient’s Experience
    (MDPI, 2024-05-30) Faith, Laura A.; Hillis-Mascia, Jaclyn D.; Wiesepape, Courtney N.; Psychiatry, School of Medicine
    Psychotherapy for individuals with psychosis is an effective treatment that promotes recovery in various ways. While there is strong quantitative evidence across modalities, less is known from the patient’s perspective. There are many varied forms of psychotherapy, and gaining the patient’s perspective can improve understanding of salient elements of psychotherapy and increase engagement, ultimately improving recovery rates. The purpose of this review is to identify and integrate data from published studies of patient perspectives of psychotherapy for psychosis to understand essential elements across approaches, differences between approaches, and how psychotherapy impacts recovery. We aimed to understand further: what are the perceptions about individual psychotherapy from the perspective of individuals with psychosis? The current study was a systematic review using PRISMA guidelines of studies that included qualitative interviews with persons with experiences of psychosis who participated in psychotherapy. All three authors participated in the literature search using Pubmed, APA PsycInfo, and Psychiatry Online. We identified N = 33 studies. Studies included cognitive therapies, acceptance and mindfulness approaches, trauma therapies, metacognitive therapy, and music therapy. All studies reported participants’ perceived benefit with the therapeutic relationship as especially salient. Participants described diverse aspects of objective (e.g., symptoms, functioning) and subjective (e.g., self-experience or quality of life) recovery improvements, with perceived mechanisms of change, and with music therapy having some unique benefits. Participants also reported challenges and suggestions for improvement. Study findings highlight the salient aspects of psychotherapy identified by patients that may help therapists to individualize and improve approaches to psychotherapy when working with individuals experiencing psychosis. Overall, findings support the potential for integrative psychotherapy approaches for maximal treatment personalization.
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    Vocational and Psychosocial Outcomes of Work Re-Integration Programs for Individuals with Severe Mental Illness: A Rapid Systematic Review
    (2020-04) Bender, Brooke; Brown, Hannah; Davis, Madyson; Lester, Lauren; Smith Jr., Carlton; Chase, Tony; Department of Occupational Therapy, School of Health and Human Sciences
    There are an estimated 11.2 million adults in the United States with a serious mental illness and this population is 6-7 times more likely to be unemployed. A systematic review of the literature related to work re-integration programs for individuals with severe mental illness was conducted to determine the role of occupational therapy in this area of practice. This included a comprehensive review of 25 studies that addressed many of the interventions commonly used in vocational and supported employment programs for individuals with severe mental illness and related mental health disorders. Findings reveal that various types of work re-integration programs result in competitive work attainment, increased job tenure, improved quality of life, and improved psychosocial factors. Occupational therapy could facilitate interventions related to work re-integration that improve vocational and non-vocational outcomes for this population. The literature over work re-integration programs is limited and more research is needed in order to understand the correlation between those with SMI and employment outcomes.